-->

Harvard Pilgrim Insurance and Abdominoplasty

mrs_rosa
on 1/11/08 7:47 am - Lynn, MA
I was told by someone that Harvard Pilgrim pays for an abdominoplasty after weightloos, anyone with feedback.  Or how do you go about getting your insurance to pay for it?
Jean M.
on 1/11/08 8:15 am
Revision on 08/16/12
A plastic surgeon did a presentation at one of my lap-band support meetings and said that no insurance covers abdominoplasty because it's considered cosmetic.  However, some insurance policies will cover panniculectomy (sp?), which removes excess abdominal skin but does not tighten up muscles, if you have a well-documented history (with photos) of chronic rashes under the skin overhang. I constantly get yeast infections in that area so when I go to my OB/GYN for my annual checkup in 2 weeks, I'm going to have her photograph my current rash and record it in her files, just in case I want to get plastic surgery later on. If I were you, I'd call my insurance company and find out exactly what they do and don't cover and what the criteria are for coverage. Jean
NHskinnygirl
on 1/11/08 8:31 am - Nashua, NH
Hi Rosa, I have had HPHC for my insurance for the last 6 yrs. I had my GPS with them, no problem with aproval for that and when I did submit to them for all of my plastics they denied my arms and breasts, and sorry Jean but that Dr doesn't know what he is taking about, they approved the inital request from Mass General Hospital for my TT . I went to Mass General as it has a PS clinic as part of the teaching hospital division of harvard medical School. I had a great experence with them, both my surgeries when well and look great and all I paid out of pocket was for my arms and breasts and it was only 5,300.00. My TT would have been 4,000.00 if HPHC had not paid for it.
Laurie in NH     Expect the Best !  You will receive the Best....
283/251/150    
                
foobear
on 1/11/08 9:07 am - Medford, MA
HPHC pays for TTs?  Woo-hoo!!!!  :-) Did you get a break in the $$$ amount for PS on your arms and breasts because you visited Mass General's PS clinic?  (I won't need work on my breasts--I hope --since I'm a guy!)  And did you get everything done at once, so that the OR fees and ansthesia fees would have been included under the covered procedure? I likewise didn't have any problem whatsoever with approval for my RNY; AFAIK, it was approved as soon as the surgeon submitted my paperwork. /Steve
NHskinnygirl
on 1/11/08 9:22 am - Nashua, NH
It is much less mooney with the clinic but you have to know that it is the chief resident that does the surgery not a board certified Doctor. There is a BC Dr. in the OR at all times but it is the residents that do the surgery. i had my arms and breasts done a lift and implants on my breasts and it cost 5,300.00 i had been quoted   18,000.00 from BC Dr.s so I would say I got a big savings on that surgery. because HPHC did pay for my GBP surgery they agreed to cover my TT with the clinic. If I had gone to a full price surgeon i am not sure they would have covered it. I loved the clinic at MGH the staff and esp. my resident was wonderful. He now is on full time staff in PS at The Brigham. I suppose I could have had it done all at once but I had a real immage problem with my arms, and a hard time getting clothes to fit correctly so I decided to do it in two surgeries 3 months apart and that made my GBP surgeon happy as he wanted us to wat 18 months before doing any surgery on our stomachs. If you want the number for the clinic just PM me and I will be happy to give it to you.
Laurie in NH     Expect the Best !  You will receive the Best....
283/251/150    
                
mrs_rosa
on 1/11/08 9:26 am - Lynn, MA

Was it the same approval process for the TT?

NHskinnygirl
on 1/11/08 9:39 am - Nashua, NH
I'm sorry Rosa, My surgeon's office did EVERY thing for my GBP I never had the stress of dealing with ins. but I do know that I was approved for that after only 1 day. As for the PS they did take full body pictures (very embarassing) and my resident did a full work up with meds and reports to forward to my insurance company for ALL of my PS requests. They did refuse the breasts and arms as they DO concider that cosmetic but the TT was covered as they believed it nesessary after my weight loss surgery and that I had lost 142 lbs in 12 months time. Hope this helps and feel free to PM me and if you want to talk i would be happy to let you know all the nifty things to expect with the clinic.....mind you if anyone wants to call MGH for an appt, you need to call the main number first for a blue card as you go nowhere there with out a blue card number and then you need to make sure to ask for the PS CLINIC not PS dept as they are two totally different dept's. and if you go to the PS dept you will have to pay full PS prices as it is a BC Dr. doing the surgeries not the residents.
Laurie in NH     Expect the Best !  You will receive the Best....
283/251/150    
                
mrs_rosa
on 1/11/08 9:50 am - Lynn, MA
Oh, I've already gotten the GBS, I'm 3 week out but I want to know what my options are for a TT, because I have excess skin from my pregnancies, but I know after the weight loss I'm sure they'll be even more excess skin! Ewwww.  But I'd be happy just with a TT,  my arms can come later on.  I'm hoping the fact that I'm only 27 will be beneficial to other saggin body parts haha...Thank you for responding. 
×